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Information presented at this week's Congressional Committee needs a much deeper evaluation and consideration. The Cochrane Masking study may even vindicate the federal government's initial COVID-19 response.
Acute COVID-19 has had an enormous impact on our nation. During a February 9, 2023, Senate Foreign Relations Committee Meeting, Senator Rand Paul stated that acute COVID-19 has been responsible for 1 million American deaths. Unfortunately, our nation has been unable to respond effectively because of abundant misinformation. Many do not believe in the dangers of long COVID, the spread of COVID-19 by children, the benefits of masking, and the need to boost one’s immunity beyond infection. These are not myths but are views that have abundant scientific support.
I agree that there is a possibility or probability of the virus escaping from a research lab. I agree with those individuals who view the efficacy of the bivalent booster to be less than expected. Dr. Paul Offit expresses caution regarding bivalent boosters in young children. Concerns also include the risks of immune imprinting. However, if one becomes infected and is not vaccinated, there is an increased risk of long COVID and concerns of immune hypofunction. For young children, discussing the risks and benefits of vaccination with your doctor is best.
The following are points that often have misconceptions:
Natural Immunity Is Superior to Vaccinated Immunity.
This is a self-fulfilling prophecy. Early on, it was stated that if the virus continued to spread, it would mutate, and the vaccine would become less effective. This has happened with the help of many individuals who discouraged adopting public health strategies. Prior to the Delta variant, the vaccine had the edge; afterward, the vaccine’s efficacy diminished. However, neither type of immunity is adequate, and whether infected or vaccinated, your immunity will wane, and a booster is beneficial to obtain hybrid immunity.
Masks Prevent COVID-19 Transmission.
The recent Cochrane study regarding the effectiveness of masking has come under extensive criticism. One of the main problems is that the study relies heavily on research evaluating the seasonal flu, a virus that is NOT felt to spread primarily by the airborne route. Early in the pandemic, Dr. Anthony Fauci advised that the public did not need to wear masks. Like the current Cochrane review, these recommendations relied heavily on existing research, much of which studied seasonal flu. This was the wrong conclusion for SARS-CoV-2 (the virus which causes COVID-19) based on extrapolated seasonal flu data.
In addition, as stated by the Cochrane study’s authors: “The high risk of bias in the trials, variation in outcome measurement, and relatively low adherence with the interventions during the studies hamper drawing firm conclusions.” Ethically, it is challenging to have non-masking controls. For example, an extensive and excellently controlled study performed in Bangladesh studied mask access and education. Both arms had masking, and there was a 29 percentage point difference in usage. Despite this, there was an 11% reduction in COVID-19 in the arm with community education, a benefit which rose to 35% in those over age 60. In addition, a recent study published in the New England Journal of Medicine observed a marked benefit in the prevention of COVID-19 spread with the use of masks in Massachusetts’ schools. One would expect that if these studies used N95 masks, the improvement would be even more significant.
Almost all mainstream scientists currently agree that SARS-COV-2 is airborne. The World Health Organization (WHO) was alerted to this by over 250 scientists in July 2020; this conclusion was supported by the National Academy of Sciences workshop on Airborne transmission of SARS-CoV-2 in October 2020. Thus, cloth masks and even surgical masks will not provide optimal protection. Well-fitted N95 masks will provide the greatest protection.
Myocarditis from the Vaccine is less common than from the infection.
Myocarditis post-COVID-19 was a well-known problem were available. A small incidence can occur post-vaccination, which is more common in young males and after the second vaccine dose. A large study published in the American Heart Association’s Journal Circulation found that the risk of myocarditis post-vaccination was lower than post-COVID-19, except for young males after the second dose of the Moderna vaccine. Several Nordic countries either paused or restricted the Moderna vaccine in young males or recommended using the Pfizer/BioNTech vaccine since it contains a lower dosage and would be expected to have a higher safety profile in this age group. In addition, vaccinations also decrease the chances of severe COVID-19 and reduce the incidence of heart attacks, strokes, and Long COVID; the latter can occur more frequently in young and middle-aged adults.
One in 5 people gets Long COVID.
Regarding long COVID, the low 3% incidence figure quoted by some authorities may have come from a United Kingdom Census survey. As of May 1, 2022, 2 million people in the UK were reported living with long COVID (or 3.1% of the population). This figure refers to the general population and not patients recovering from COVID-19. An incidence of 10% to 30% following COVID-19 is commonly reported. Children developing long COVID is also a concern. A January 3, 2023, article in the New York Post describes a heartbreaking case of long COVID in a child. It references a BBC article reporting that 100,000 children in the UK have this debilitating condition. The University College of London and Public Health England reported that as many as 1 in 7 children with COVID may have persistent symptoms after COVID-19. A study in Scientific Reports, found a higher incidence of 25%.
School Closures Reduce COVID-19 Transmission
Abundant evidence exists that children can spread COVID-19. A Korean case tracking study published in Oct. 2020 found that older children can spread SARS-CoV-2 as easily as adults. In Sweden, a country of only 10.4 million individuals, data regarding children spreading SARS-CoV-2 in schools has been brought into question with the reporting of governmental emails which "speculated about the use of children to acquire herd immunity.” There was also a lack of transparency about outbreaks in Swedish schools, with parents often not being notified of infections. In mid-December, The Public Health Agency of Sweden Weekly Report #50 states: “(translated) among the environments for the public (excluding health care) was primary school, the environment from which the most outbreaks were reported in week 50…” (Total outbreaks 199, Nursery Schools 39, Elementary Schools 90, Grammar Schools 23, Workplace 39, High Schools were closed. See Table.) However, there is evidence that schools can open safely, if they also apply a bundle of mitigation strategies. The masking of students and teachers was the most common intervention.
In conclusion, one cannot spend the past 3 years discouraging compliance with public health strategies by expounding their ineffectiveness measures and expect them to be successful. The efficacy of our current vaccines is waning, and long COVID is a substantial risk, even to the young. For high-risk individuals, which includes about half of the United States’ population it is best to keep current on vaccinations, use masking in poorly ventilated indoor environments, along with testing and seeking medical care if one becomes infected.